scholarly journals Bariatric surgery: a potential cure for asthma?

2019 ◽  
Vol 28 (152) ◽  
pp. 190003 ◽  
Author(s):  
Toufic A. Chaaban
Keyword(s):  
Bariatric Surgery ◽  
Long Term Outcomes ◽  
Asthmatic Patients ◽  
Asthma Incidence ◽  
Related Hospitalisation ◽  
Asthma Outcomes ◽  
Weight Loss Interventions

Asthma incidence and severity are increased in obese populations. Systematic reviews have shown benefit from weight-loss interventions on asthma outcomes, but the role of bariatric surgery is still unclear. In this review, cohorts of obese asthmatic patients undergoing bariatric surgery were examined regarding different asthma outcomes. The available data on patients who were followed up showed improvements in asthma control, exacerbation risk, asthma-related hospitalisation, medication use and airway hyperresponsiveness, with some patients not requiring further treatment for asthma. Follow-up duration was variable, being mostly of 1 year, with some studies reporting long-term outcomes after 5 years. The studies reviewed had many limitations, including small numbers of patients, lack of control arm in some studies and lack of standardisation of asthma diagnosis, classification and outcome measures, in addition to possible reporting bias. Data on small numbers of patients also show the possibility of benefit exclusively in nonallergic asthma. Larger, more stringent clinical trials are needed before recommending bariatric surgery for treatment of asthma.

A New Role of Staged Tympanoplasty for Cholesteatoma

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P52-P52
Author(s):  
Yasuyuki Hinohira ◽  
Naoaki Yanagihara ◽  
Naohito Hato
Keyword(s):  
Mastoid Cavity ◽  
Pathological Findings ◽  
Long Term Outcomes ◽  
Retraction Pocket ◽  
Endoscopic Observation ◽  
Middle Ear Cholesteatoma ◽  
Long Term Follow Up

Objective 1) Investigate a correlation between pathological findings at the 2nd stage operation and long-term outcomes in a staged canal wall-up tympanoplasty (SCUT) for middle ear cholesteatoma. 2) Advocate a new role of the staged manner based on the study. Methods SCUT was performed on 90 ears with cholesteatoma involving both the ossicles and the mastoid cavity. The 1st stage operation included scutum plasty and mastoid cortex plasty with bone pate following removal of cholesteatoma and ossicles involved. The 2nd stage operation records were reviewed regarding the pathological findings associated with retraction pocket (RP) and residual cholesteatoma (RC) formation. The scutum defect was revised with auricular cartilage, and the mastoid cortex plasty was again performed after removal of RC. Postoperative follow-up with endoscopic observation and CT was performed for all patients. Results At the 2nd stage, RP was seen in 15 ears (16.7%) which all showed partial or total absorption of the scutum reconstructed. Aeration grade of the mastoid cavity reconstructed did not correlate with RP or RC formation. RC was found in 28 ears (31.1%) regardless of RP formation. The long-term follow up study revealed that the statistically higher incidence of RP re-formation (26.7%) and RC (3.2%) was seen in ears which had been identified at the 2nd stage, respectively. Conclusions The present study showed that the long-term outcomes after SCUT were correlated with RP and RC formation at the 2nd stage. This indicates the 2nd stage operation has a role of the long-term prognosis in addition to exploration of RC.

scholarly journals Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis

2017 ◽  
Vol 5 (3) ◽  
pp. 165-173 ◽  
Author(s):  
Thomas H Inge ◽  
Todd M Jenkins ◽  
Stavra A Xanthakos ◽  
John B Dixon ◽  
Stephen R Daniels ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Severe Obesity ◽  
Long Term Outcomes

scholarly journals Bariatric surgery proves long-term benefit in patients with cirrhosis

2020 ◽  
Author(s):  
Manhal Izzy ◽  
Mounika Angirekula ◽  
Barham K Abu Dayyeh ◽  
Fateh Bazerbachi ◽  
Kymberly D Watt
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Descriptive Analysis ◽  
Total Body Weight ◽  
Hepatitis C Infection ◽  
Long Term Outcomes ◽  
Hepatic Decompensation ◽  
Compensated Cirrhosis

Abstract Background Obesity is commonly observed in patients with cirrhosis, especially with the increasing prevalence of non-alcoholic steatohepatitis (NASH). Bariatric surgery has been avoided in these patients given concerns about increased perioperative risk; therefore, data are lacking regarding long-term outcomes. In this study, we aimed to evaluate the long-term outcomes of patients with cirrhosis who underwent bariatric surgery. Methods We reviewed the charts of adult patients with compensated cirrhosis who underwent bariatric surgery after they were prospectively enrolled between February 23, 2009 and November 9, 2011, and followed in a pilot study for evaluation of bariatric surgery outcomes. Only patients with more than 4 years of follow-up were included in the analysis. Data regarding their liver disease, metabolic status, and survival were collected. A descriptive analysis was performed. Results The cohort consisted of 10 patients, of whom 7 were females. The median post-surgical follow-up was 8.7 years (± 1.4 years). All patients had biopsy-proven NASH; two patients had concurrent, untreated hepatitis C infection. During the observation period, there was a mean weight loss of 24 kg (19.2% of total body weight pre surgery, P < 0.001) and only one patient regained weight to the baseline pre-surgical measurement. One patient who was not eligible for transplant developed hepatic encephalopathy 3 years after surgery and later died. The remainder of the patients did not have any hepatic decompensation, cardiovascular event, or mortality. Except for one patient with Gilbert syndrome, bilirubin was normal in all patients at last follow-up. Conclusions Bariatric surgery in patients with compensated cirrhosis can lead to sustained weight loss and stable hepatic function on long-term follow-up.

Prediction of ventilator-associated pneumonia outcomes according to the early microbiological response: a retrospective observational study

2021 ◽  
pp. 2100620
Author(s):  
Adrian Ceccato ◽  
Cristina Dominedò ◽  
Miquel Ferrer ◽  
Ignacio Martin-Loeches ◽  
Enric Barbeta ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Multivariable Analysis ◽  
Ventilator Associated Pneumonia ◽  
Long Term Outcomes ◽  
Microbiological Criteria ◽  
Short And Long Term ◽  
Current Guidelines

Ventilator-associated pneumonia is a leading infectious cause of morbidity in critically ill patients; yet current guidelines offer no indications for follow-up cultures.We aimed to evaluate the role of follow-up cultures and microbiological response 3 days after diagnosing ventilator-associated pneumonia as predictors of short- and long-term outcomes.We performed a retrospective analysis of a cohort prospectively collected from 2004 to 2017. Ventilator-associated pneumonia was diagnosed based on clinical, radiographic, and microbiological criteria. For microbiological identification, a tracheobronchial aspirate was performed at diagnosis and repeated after 72 h. We defined three groups when comparing the two tracheobronchial aspirate results: persistence, superinfection, and eradication of causative pathogens.One-hundred-fifty-seven patients were enrolled in the study, among whom microbiological persistence, superinfection, and eradication was present in 67 (48%), 25 (16%), and 65 (41%), respectively, after 72hs. Those with superinfection had the highest mortalities in the intensive care unit (p=0.015) and at 90 days (p=0.036), while also having the fewest ventilation-free days (p=0.024). Multivariable analysis revealed shock at VAP diagnosis (odds ratios [OR] 3.43; 95% confidence interval [CI] 1.25 to 9.40), Staphylococcus aureus isolation at VAP diagnosis (OR 2.87; 95%CI 1.06 to 7.75), and hypothermia at VAP diagnosis (OR 0.67; 95%CI 0.48 to 0.95, per +1°C) to be associated with superinfection.Our retrospective analysis suggests that ventilator-associated pneumonia short-term and long-term outcomes may be associated with superinfection in follow-up cultures. Follow-up cultures may help guiding antibiotic therapy and its duration. Further prospective studies are necessary to verify our findings.

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